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0 pointsjandrewrogers13y ago0 comments

Actually, yes, they treat people with no insurance with cancer or other serious injuries all the time. I was literally sitting in an emergency room at Stanford when they flew in a poor illegal immigrant from Fresno and did the micro-surgical reattachment of a finger. I was there for someone with no insurance who had stage 4 liver cancer who was undergoing treatment (they survived). I grew up very poor, there was nothing unusual about this.

The idea that poor people do not get top notch medical care in the US is largely a myth. It might not be quite as nice but it is often nearly as effective. A large part of the reason medical care is so expensive for average people is that they are subsidizing the healthcare of poor people. This is why the average survival rates for most cancers are higher in the US than anywhere else in the world; people that cannot afford it still get treated with the state of the art and the cost is passed on to people with insurance.

A poor person with cancer in the US with cancer has a much higher survival rate than the average person in the UK. Poor people may not have official insurance but that does not imply lack of healthcare in practice.

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7 comments · 4 top-level

robbiep13y ago· 2 in thread

This is the second time I have seen this claim (re cancer survival) posted to HN, both times it has been unsupported by any references-

Do you have any references?

I have been able to find this

Global Cancer Statistics, 2002 DOI 10.3322/canjclin.55.2.74 That shows essentially the same survival between the US and western Europe. (Link to table http://i.imgur.com/UWPxDEx.png )

Which contradicts the claim

Someone13y ago

I think they refer to http://www.thelancet.com/journals/lancet/article/PIIS1470-20... (I think http://healthcare.procon.org/sourcefiles/CONCORDCancerSurviv... is a freely available copy). It shows th USA consistently in the top 5, but not always the top.

I think they worked hard on getting comparable data, but I find the discussion on where they come from somewhat lacking. There is some discussion on inconsistencies between diagnoses (when is something Cancer X?), but I could not find a discussion on QALy's (http://en.wikipedia.org/wiki/Quality-adjusted_life_year). I expect that can make a decent difference in 5 year survival rates (if you give patients the choice between 6 months in bed in hospital and 3 months at home, the last on bedridden, quite a few would choose the 3 months)

robbiep13y ago

Thank you for that.

I suppose I generally consider that when US/UK cancer survival is brought up in this manner it inflates US medical treatment and uses the UK as a proxy for western rest of the world medical treatment - however this isn't true as Cuba, France, Canada and Australia for example hve essentially the same survival from that chart as US survival...

ck213y ago· 1 in thread

You have no idea what you are saying and are under some kind of fantasy. I live the reality you are speculating about.

EMERGENCY CARE must be admitted, ie. loss of a finger - it most certainly is not free and that person will never be able to get credit for the rest of their life (unless they can somehow afford to repay it - but an ambulance flight in is at least $10k alone)

They are under no obligation to treat cancer. If you were bleeding out from the final stages, they might have to admit you. Otherwise it's not an emergency. You are free to die slowly.

If you don't catch the cancer early on and can get some federal assistance to get it treated, you are pretty much screwed. They pretty much know with cancer you aren't going to be paying them back for any services rendered, so none rendered.

If you are a step above federal poverty level yet still cannot afford to pay for medical or dental treatment in this country, you are screwed. Your entire income will be consumed as you get older by medical needs. If you get cancer, your best bet is to then make sure your income completely disappears and apply for all the assistance you can get, your job income then becomes a liability.

seanmcdirmid13y ago

> If you don't catch the cancer early on and can get some federal assistance to get it treated, you are pretty much screwed. They pretty much know with cancer you aren't going to be paying them back for any services rendered, so none rendered.

So you are calling parent a liar? That his story can't be true because someone without insurance but with liver cancer would just die under our heartless system?

> If you are a step above federal poverty level yet still cannot afford to pay for medical or dental treatment in this country, you are screwed.

You definitely have a problem, but I think you severely underestimate the amount of charity care that goes on in the US, which is why our hospitals charge so much anyways. You can go to the hospital, get treatment, they will bill you later, and...they won't run a credit check first.

> If you get cancer, your best bet is to then make sure your income completely disappears and apply for all the assistance you can get, your job income then becomes a liability.

You can get charity care without being on medicaid.

purple_peon13y ago

Very rare around this area. In fact, the emergency rooms here won't fully treat people sometimes because of lack of a regular doctor, which requires payment and regular checkups and things the poor cannot do. "free clinics" drop off not too far from the poverty line.

That person with stage 4 liver cancer? What if it were skin cancer - it looked funny, but they can't get it checked out. Until it is an emergency... and by then it could be too late. Even then, the emergency room will say it is too big to treat from there and refer to the normal doctor most times. This isn't top notch medical care. This is "suffer until it is dire, and maybe you'll wind up surviving in pain"

I'd much rather pay an insurance tax so everyone is covered. I doubt it would be much more than people pay now for insurance since everyone would be paying in.

nemesisj13y ago

Look, I think the point is this:

We have universal healthcare coverage in the USA, the difference between the USA and everywhere else is we'll bankrupt you first in order for you to access it.

This is an incredibly inefficient, heartless, and needless way to run things, yet it's what we have. I see a few comments below you talk about no access to cancer or chronic care if you're poor but there are tons of programs, grants, etc. that you can access, except you must be genuinely poor. And spend a lot of time finding them, and filling out paperwork, and on and on and on. You'll get care, but it will be psychologically, financially and physically demanding for you and everyone around you.

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